Ashraf O Oweis, Sameeha A AllShelleh, Bara' Al-Zu'bi, Batool A AlAjlouni, Haneen A Shawer, Karem H Alzoubi
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引用次数: 0
Abstract
Background: End-stage renal disease (ESRD) patients on hemodialysis are at higher risk for cardiovascular complications due to the increased risk of atherosclerosis. This study aims to evaluate the factors associated with poor outcomes in this group of patients with Peripheral arterial disease (PAD) regarding survival and rates of lower limb amputation, which is an important determinant of morbidity and quality of life.
Methods: A retrospective analysis was performed using hospital databases from 2010 to 2021. ESRD patients who were diagnosed with PAD during this period were studied; diagnosis was done through CT-angiography. Predefined endpoints were death and amputation.
Results: The mean age for the patients was 65.9 (SD 12.96) and 66.7% were males. Most patients had either DM (84.6%) or HTN (91%). The prevalence of amputation was 44.7%, 32.9% were males (P=0.33); using univariate analysis DM was a strong predictor for amputation (P=0.001) as long as coronary artery disease (P=0.001) while other comorbidities like HTN (P=0.66), heart failure (P=0.86), atrial fibrillation (P=0.81), Dyslipidemia (P=0.95) and stroke (P=0.16) were not associated with amputation. On multivariate analysis, only DM (P=0.003) was associated with a higher prevalence of amputation Time to death was 16.9 months (SDܸ25.6), 11.3 months (SDܸ9.1) for patients with amputation vs. 21.1 (SDܸ32.7) for those without amputation.
Conclusion: End-stage renal disease patients with PVD, especially with PVD, have higher mortality, and the majority are diabetic, which necessitates earlier recognition of PVD and modified risk factors like better control of DM and its complications in addition to other risk factors like HTN, dyslipidemia, and metabolic disorders of CKD.
期刊介绍：
Current Vascular Pharmacology publishes clinical and research-based reviews/mini-reviews, original research articles, letters, debates, drug clinical trial studies and guest edited issues to update all those concerned with the treatment of vascular disease, bridging the gap between clinical practice and ongoing research.
Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials. Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units).
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